Recalculation of Secular Trends in Paget's Disease


In 2002, Rogers et al. reported on the prevalence of Paget's disease in a large skeletal population from the site of Barton-on-Humber in northeast England in this journal.(1) The burials at the site ranged in time from late Anglo-Saxon to the middle of the 19th century, and the authors noted that there was some evidence that the prevalence of Paget's disease had increased during the last thousand years. Since Juliet Rogers' untimely death in September 2001, the phasing at Barton-on-Humber has undergone substantial revision in the light of new archaeological information, and a number of errors in the database have also been corrected. The Paget's disease data have been re-analyzed, and the prevalence of the disease was recalculated using the same entry criteria into the study as in the original paper; that is, only individuals 40 years of age or more at the time of death and with at least 40% of the skeleton preserved were included.

Fifteen cases of Paget's disease were diagnosed by the earlier authors, and these were now found to have occurred in 611 individuals who met the entry criteria, a prevalence of 2.5% (95% CI, 1.5–4.0%). After the rephrasing, it was found that nine of the cases died before 1500 and five after that date; the remaining case could not be tightly phased to either the earlier or later periods and had to be excluded from further analysis. These figures differ from those quoted by Rogers et al. who were using the previous unrevised phasing data. The prevalence of Paget's disease before and after 1500 is now shown to be 2.5% in each case (95% CI, 1.3–4.6% and 1.1–5.7%, respectively). These new data indicate that the prevalence of Paget's disease has not changed over the 1500 years covered by these burials, and the earlier conclusion that there may have been an increase in the rate of the disease cannot now be sustained. The original authors' description of the distribution of the lesions is, of course, unaltered, and their conclusions in this respect still stand.

The data relating to the entire pathology of the site are currently being re-analyzed, and it is hoped that the final report on the site will be ready for publication in 18 months.